Boston University Sargent College of Health & Rehabilitation Sciences
Center for Psychiatric Rehabilitation

Boston University Sargent College of Health & Rehabilitation Sciences
Center for Psychiatric Rehabilitation

What Accommodations Support School Performance?

For college students with psychiatric and mental health conditions, and resulting disabilities, academic accommodations may include adaptations in the way specific courses are conducted, the use of extra technology or equipment, supports, or modifications in academic requirements. Many colleges and universities have both the diversity of resources and the flexibility to provide aids or services as accommodations. It is important that aids and services be selected in consultation with student who will use them.

The examples below of potential accommodations are provided for descriptive purposes only. Note that every student has different needs and preferences and each of the suggestions should be tailored to the individual. Academic adjustments are intended to allow students with disabilities to successfully master their coursework and are not intended to circumvent academic standards or requirements.

Classroom Accommodations

These are provided as examples of potential accommodations but note that every student has different needs and preferences and each of the suggestions should be tailored to the individual. 

  • Preferential seating
    Seating in a preferred location, by the front door, or to reduce audio/visual distractions. 
  • Coach / Mentor
    Having someone (another student for example) accompany a student to class and/or stay in class with the student. 
  • Assign classmate as a volunteer assistant
    Similar to an accompanier, a volunteer assistant may help take notes or provide informal support. 
  • Beverages permitted in class
    Helps alleviate dry mouth or tiredness caused by medications. 

Lecture accommodations 

  • Pre-arranged breaks
    Helps student anticipate and manage anxiety, stress, or extreme restlessness caused by medication. 
  • Audio Recorder
    Alleviates pressure of note taking, freeing the student to attend and participate more fully in class. 
  • Note taker
    Similar to above, having someone in class to take notes alleviates the anxiety of having to capture all the information; sometimes the anxiety of attending class interferes with effective note taking. 
  • Using another student’s notes
    If note takers are not available, then securing notes from another student helps free him or her to attend and participate more fully in class. 

Examination accommodations 

  • Change in testing format
    Altering an exam from a multiple choice format to an essay format may help students demonstrate their knowledge more effectively and with much less interference from anxiety or a learning disability. 
  • Permit use of technological assistance
    Writing may be difficult due to medication side effects that create muscular or visual problems; using a variety of tech support or devices can be helpful. 
  • Extended time 
    Allowing extra time for exams, to be negotiated before the exam, allows the student to focus on the exam content instead of the clock, and lessens the chance that anxiety or other symptoms will interfere with his or her performance. 
  • Segmented
    Dividing an exam up into parts and allowing the student to take them in two or three sessions over 1-2 days helps reduce the effect of fatigue and allows the student to focus on one section at a time. 
  • Permit exams to be individually proctored 
    A non-distracting, quiet setting helps reduce interference from anxiety or other symptoms or medication side effects.
  • Increase the frequency of tests or examinations
    Giving thstudent more opportunities to demonstrate knowledge creates less pressure than having just a midterm or a final. 
  • Permit exams to be read orally, dictated, scribed, or typed.
    Anxiety, other symptoms, medication side effects, or a learning disability may interfere with mental focus, concentration, ability to retrieve information, and/or writing capacity during a typical paper-pencil test. Reducing the amount of external pressure and distractions gives the student an equal opportunity to demonstrate his or her expertise without the mental health condition skewing the results. 

Assignment accommodations

  • Substitute assignments
    Other exercises may be considered for a student with a psychiatric or mental health condition to best demonstrate their grasp of the required knowledge.
  • Advance notice of assignments
    Helps a student anticipate and plan time, energy, and workload, and arrange for any support or academic adjustments. 
  • Delay in assignment due dates
    Extra time on a due date might be all that is needed for a student to pass course. The delay should be specified; i.e., a new due date should be negotiated and formalized, not be left open-ended. 
  • Assignment assistance during periods of difficulty
    Staying connected to a student while he or she is experiencing difficulty coming to classes may mean the student can finish the course as planned and not have to take an incomplete or withdrawal grade, lose their money, or repeat the course again. (The exacerbation of symptoms does not necessarily preclude the student’s ability to complete schoolwork, and in some cases may help them meet their academic responsibilities.) 
  • Use alternative forms for students to demonstrate course mastery
    A student may be better able to demonstrate his or her knowledge in ways that don’t require lots of writing (e.g., a narrative audiotape instead of a written journal) or time pressure (an essay exam rather than only multiple-choice, or an extra paper if the student has not performed well on the exam due to his or her symptoms). 
  • Textbooks on tape
    May help a student whose vision or concentration interferes with their reading ability. 

Administrative accommodations

  • Providing modifications, substitutions, or waivers of courses, major fields of study, or degree requirements on a case-by-case basis.
    These adjustments should be considered on an individual basis, and only if the changes requested would not substantially alter essential elements of the course or program, or if courses are required for licensure) 
  • Provide orientation to campus and administrative procedures.
    Increasing a student’s familiarity with a college or university environment and the system helps him or her to feel more confident and confident, and allow the student to plan, strategize, anticipate trouble spots, and know where to go for assistance. 
  • Provide assistance with registration/financial aid.
    Helping a student cut through red tape and coaching them through the intricate but critical process of financial aid eliminates a potentially debilitating amount of stress and hassle. 
  • Flexibility in determining “Full-Time” status (for purposes of financial aid and health insurance).
    A school often has the power to declare a student “full-time” even if he or she is part-time. If the psychiatric condition is such that a part-time load is equal in burden to a full-time load for a student without disability, such a case can be made.
  • Assistance with selecting classes and course load.
    Early morning classes or high-stress classes, could set a student up failure.
  • Parking passes, elevator key, access to a lounge.
    Anxiety and other psychiatric symptoms can physically and emotionally prevent a student from crossing the campus or climbing several sets of stairs or sustaining energy for a day of classes when they would otherwise be capable of attending class. These supports make the environment more accessible and “friendly,” and are usually cheap and easy to obtain. 
  • Incompletes rather than failures or withdrawals if relapse occurs.
    If a student has finished most of the coursework but is unable to complete the remainder before the semester’s end, negotiating an incomplete can be beneficial because it may mean that a student will not have to repay or retake the entire course in order to finish it. 
  • Identified place to meet on campus that feels “safe” before or after class.
    Having a place that is safe may help a student attend class more regularly and help lessen the effects of anxiety and avert stresses that can exacerbate other psychiatric symptoms.


Case Illustrations of Classroom Accommodations


Jennifer was enrolled in a beginning computer class. Due to her symptoms of her psychiatric condition, she had difficulty focusing in class. Her thoughts would wander from the lecture, and often she would feel lost in class. When this happened, she would interrupt the class to ask the professor questions. She noticed that classmates were annoyed by her disruptions. 

Jennifer’s teacher allowed her to bring in an audio recorder to tape the class lectures. She also was assigned a “buddy,” a classmate who would sit next to her during class to point out what they were focusing on if Jennifer became lost. The professor also made herself available to Jennifer each week at a certain time for questions. Jennifer also increased her time in the computer lab at the school.

Lisa was in her second semester at a community college. She had been taking three classes and was near completion of the semester when her symptoms began to affect her school work. Until this point, Lisa had been an exemplary student, with a grade point average of 4.0. It became impossible for Lisa to go to her classes. Lisa did not want to jeopardize her grade point average, nor did she have the financial resources to retake the classes. 

Because of her exemplary record, Lisa’s professors all agreed to give her an incomplete rather than having her withdraw or failing her. This enabled Lisa to complete the course work over the next semester. It would not affect her grade point average and she would not have to pay for the classes again.

Joe was attending a major metropolitan university. The parking lot for the university was quite a distance from the building were his classes took place. Because of an anxiety disorder, Joe would find himself experiencing panic attacks walking from his car to the classroom building. Once he arrived in the building it would take him several minutes to calm himself and he was generally very flustered during his class. Joe was contemplating quitting school. 

Joe approached the Students with Disabilities Office and was able to get a parking pass which allowed him to park closer to the building where his classes were held. Because of this, he felt safer in the environment and no longer experienced the panic attacks on his way to class.

NOTE: The information contained in these pages is for educational purposes only, and is not legal advice. Individuals should contact the appropriate legal resources for specific legal advice regarding their particular situations.